[Appendicovesicostomy for controlled bypass of urine in children].

Catheterization through appendicovesicostomy (AVS) proposed Mitrofanoff in 1980 is an alternative of periodic catheterization of the urinary bladder via urethra. AVS was used in 30 children (21 boys and 9 girls). Appendix with intact mesentery was cut off the caecum and placed between the urinary bladder or artificial urinary bladder and the skin in the umbilical area. The immediate postoperative period was uneventful--complications were absent. 3 to 6 month follow-up registered obstruction in the created appendicostomas in 7 children. Urinary leakage from the "stoma" occurred in 3 patients. They have undergone corrective surgery. Surgical outcomes were studied 6 months to 5 years after the intervention in 25 patients. The appendicostomas were well passable for the catheter in all the patients. Urine did not leak, cosmetic results were satisfactory. AVS provides controlled urine bypass, social adaptation of children, control of urogenital inflammation. When conducting appendicostomy, extended cutaneo-appendicular anastomosis should be created, tonnel technique in anastomosis with the urinary bladder should be used. In anastomosis of the appendix with the intestinal reservoir, reliability is warranted by a retaining valve of the nipple type.